Perceptions of the Use of Alcohol and Drugs after Sudden Bereavement by Unnatural Causes: Analysis of Online Qualitative Data

Abstract

Bereavement is associated with an increased risk of psychiatric morbidity and all-cause mortality, particularly in younger people and after unnatural deaths. Substance misuse is implicated but little research has investigated patterns of drug or alcohol use after bereavement. We used a national online survey to collect qualitative data describing whether and how substance use changes after sudden bereavement. We conducted thematic analysis of free-text responses to a question probing use of alcohol and drugs after the sudden unnatural (non-suicide) death of a family member or a close friend. We analysed data from 243 adults in British Higher Education Institutions aged 18–40, identifying two main themes describing post-bereavement alcohol or drug use: (1) sense of control over use of drugs or alcohol (loss of control versus self-discipline), (2) harnessing the specific effects of drugs or alcohol. Across themes we identified age patterning in relation to substance misuse as a form of rebellion among those bereaved in childhood, and gender patterning in relation to men using alcohol to help express their emotions. The limitations of our sampling mean that these findings may not be generalizable from highly-educated settings to young people in the general population. Our findings describe how some young bereaved adults use drugs and alcohol to help them cope with traumatic loss, and suggest how clinicians might respond to any difficulties controlling substance use.

Self-Reported Patterns of Use of Alcohol and Drugs After Suicide Bereavement and Other Sudden Losses: A Mixed Methods Study of 1,854 Young Bereaved Adults in the UK

“…In relation to other qualitative research, our own thematic analyses of these data specifically for people bereaved by suicide (Eng et al, 2019), and non-suicide unnatural deaths (Drabwell et al, 2020), identified that for both groups struggles over control with alcohol or drugs were prominent and many used substances for specific ends. For those bereaved by non-suicide unnatural causes these ends included gaining a release, escaping reality, and achieving emotional openness (Drabwell et al, 2020). For those bereaved by suicide, they included coping with overwhelming emotions, and honoring the memory of the deceased (Eng et al, 2019).…”

“…drove efforts to control their use (Eng et al, 2019;Drabwell et al, 2020). A thematic analysis of interviews with 57 young British men aged 19-35 who had been bereaved by non-suicide unnatural causes found many similar themes (Creighton et al, 2015).…”

“…No other study to our knowledge has collected similar data, so this constitutes the best available evidence. Our thematic analyses of data for people bereaved by suicide (Eng et al, 2019), and by accidental death (Drabwell et al, 2020), were conducted with lead researchers blind to the coding used in this study, and provide further insights into the reasons for underlying behavior change in this sample.…”

We Need to Delay the Age of Onset of Alcohol Consumption

“…Drabwell et al [34] analyzed alcohol consumption after sudden bereavement by unnatural causes among adults aged 18 to 40. Their results show how men use alcohol to facilitate the expression of emotions, while in young people it was more common as a form of rebellion.…”

Consumo de álcool durante a pandemia da COVID-19: uma reflexão necessária para o enfrentamento da situação

“…Some studies point to intensified alcohol use in grieving situations 30 . Thus, as COVID-19 emerges as one of the main causes of death, there is additional concern about alcohol consumption patterns during isolation and in the coming years.…”